DESCRIPTION

The tibial tubercle is usually moved medially and anteriorly to improve the ‘Q’ angle and patella tracking. The strength of fixation of the transferred tibial tubercle will shape the surgeon’s decision on whether or not a splint is required post operatively.

Elevation of the limb
Isometric quadriceps – V.M.O. especially
Muscle pump exercises
P.W.B. (in cricket splint as necessary)
Gentle R.O.M. exercises
Patella mobilisation

Progress to include:
Hamstring exercises.
Gradually increase range of movement but do not force.
Remain P.W.B. if not in a splint.
May be able to FWB if in a cricket splint.

(Some protection required – crutches or splint – to prevent giving way or sudden strong quadriceps contraction).

Progress to F.W.B. and abandon splint
Begin graduated quadriceps strengthening
CKC activity and proprioceptive training
Stretching all muscle groups
Full range hamstring contractions

Pain free
No swelling
Full function
Improved timing of VMO

+ ACUTE STAGE

Elevation of the limb
Isometric quadriceps – V.M.O. especially
Muscle pump exercises
P.W.B. (in cricket splint as necessary)
Gentle R.O.M. exercises
Patella mobilisation

+ SIX WEEKS

Progress to include:
Hamstring exercises.
Gradually increase range of movement but do not force.
Remain P.W.B. if not in a splint.
May be able to FWB if in a cricket splint.

(Some protection required – crutches or splint – to prevent giving way or sudden strong quadriceps contraction).

+ SEVEN DAYS

Progress to F.W.B. and abandon splint
Begin graduated quadriceps strengthening
CKC activity and proprioceptive training
Stretching all muscle groups
Full range hamstring contractions

+ CONDITIONS FOR DISCHARGE

Pain free
No swelling
Full function
Improved timing of VMO

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